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特立帕肽对转子间髋部骨折内固定术后临床及影像学长期疗效的影响

Effects of Teriparatide on Clinical and Radiologic Long-Term Outcomes after Fixation of Pertrochanteric Hip Fractures.

作者信息

Hosseini Khameneh Mehdi, Gorji Mona, Jafari Kafi-Ababdi Meisam, Biglari Farsad, Gholipour Morteza, Asadi Keivan, Sabbaghzadeh Amir

机构信息

Clinical Research Development Unit of Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Adv Biomed Res. 2023 May 30;12:139. doi: 10.4103/abr.abr_127_22. eCollection 2023.

Abstract

BACKGROUND

Pertrochanteric hip fractures are common and among serious injuries of the old population with considerable mortality and morbidity. The aim of this study was to evaluate long-term effects of recombinant human parathyroid hormone on postoperative clinical and radiologic outcomes in elderly patients with pertrochanteric hip fractures.

MATERIALS AND METHODS

Between 2016 and 2019, we prospectively assessed 80 patients with pertrochanteric hip fractures who underwent reduction and internal fixation with a dynamic hip screw. Patients were divided randomly into two groups. About 40 patients in the control group who received supplementary calcium (1000 mg/day) and vitamin D (800 UI/day), and 40 others who were treated additionally with 20-28 mg daily teriparatide for three months post-operatively. The functional and radiologic assessment was done using visual analog scale (VAS), Harris hip score (HSS), and standard radiographs of the hip.

RESULTS

At the final follow-up, there was a significant difference between the two groups regarding average HSS (68.38 in the control group versus 74.12 in the treatment group, -value <0.001). VAS score was also significantly lower in the treatment group (-value <0.001). Regarding radiographic evidence of union, the results were not statistically different between the two groups.

CONCLUSIONS

The current study illustrated that short-term daily administration of teriparatide improves long-term functional outcome after pertrochanteric hip fracture fixation and can reduce the pain but does not affect union and callus formation.

摘要

背景

股骨转子间髋部骨折很常见,是老年人群的严重损伤之一,具有相当高的死亡率和发病率。本研究的目的是评估重组人甲状旁腺激素对老年股骨转子间髋部骨折患者术后临床和影像学结果的长期影响。

材料与方法

2016年至2019年期间,我们前瞻性评估了80例接受动力髋螺钉复位内固定术的股骨转子间髋部骨折患者。患者被随机分为两组。对照组约40例患者接受补充钙剂(1000毫克/天)和维生素D(800国际单位/天),另外40例患者术后三个月每天额外接受20 - 28毫克特立帕肽治疗。使用视觉模拟量表(VAS)、Harris髋关节评分(HSS)和髋关节标准X线片进行功能和影像学评估。

结果

在最后一次随访时,两组之间的平均HSS存在显著差异(对照组为68.38,治疗组为74.12,P值<0.001)。治疗组的VAS评分也显著更低(P值<0.001)。关于骨愈合的影像学证据,两组之间的结果无统计学差异。

结论

本研究表明,短期每日给予特立帕肽可改善股骨转子间髋部骨折内固定术后的长期功能结局,并可减轻疼痛,但不影响骨愈合和骨痂形成。

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本文引用的文献

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